Program Director : Thomas Roy, M.D.
GENERAL: The Division of Pulmonary, Critical Care and Sleep Disorders Medicine is part of Internal Medicine Program of the Department of Medicine at the Quillen College of Medicine at East Tennessee State University. The Fellowship teaching program in pulmonary disease has been ongoing since 1980. There are over 46 graduates of the program located in 10 different states. The division was accredited by the ACGME in 1995 as a combined pulmonary/critical care training program. The majority of graduates who have taken the subspecialty board examinations in pulmonary disease and critical care have been certified. The training program is three years, preparing candidates for certification in both subspecialty boards of pulmonary disease and critical care. Two new fellowship positions are offered each year.
MISSION: Our mission is to deliver excellent, efficient, state-of-the-art and evidence-based medical care to our patients, provide outstanding educational and training opportunities for students, residents and post-graduate trainees, and to promote and foster multi-disciplinary clinical and basic science research programs designed to improve our understanding of human health and disease with the goal of improving quality of life, preserving and restoring respiratory and sleep health.
FACULTY: Our Faculty consists of board-certified physicians in pulmonary disease, critical care, and sleep medicine. They provide the latest evidence-based treatments for a number of disorders including: asthma, chronic obstructive pulmonary disease, emphysema, occupational lung disease, pulmonary vascular diseases, interstitial lung diseases, critical care/intensive care medicine, cystic fibrosis, pulmonary infections, tuberculosis, lung cancer and common and more complex sleep disorders like sleep apnea, insomnia, restless legs syndrome and narcolepsy.
Areas of particular interest to the faculty include, but are not limited to, idiopathic pulmonary fibrosis, asthma/COPD, complex sleep disorders, lung cancer and management of adult respiratory distress syndrome and septic shock. Diagnostics, treatment and management, and educational programs are focused on the needs of patients and their families.
Our Faculty and Fellows publish scholarly activity that involves basic research as well as clinical research aimed at improving respiratory clinical care and sleep health.
TRAINING FACILITIES: Several teaching hospitals are utilized. These are the Bristol Regional Medical Center, The Holston Valley Medical Center, the Johnson City Medical Center, and the James H. Quillen Veterans Administration Hospital.
In two of the main teaching hospitals (Bristol Regional and VA), the Fellows provide first line care in the medical intensive care units as part of a comprehensive multidisciplinary team. Fellows, in conjunction with faculty preceptors, perform pulmonary consultations on hospitalized patients at each facility. Two of our training facilties are Level 1 trauma centers. Bristol Regional Hospital also provides our Fellows the opportunity for long term ventilator care and rehabilitation medicine. Fellows participate in ambulatory care clinics (both at the VA and the University ) in which continuity of care for patients with pulmonary disease is stressed. The Division is responsible for special diagnostic procedures such as pleural biopsy, lung biopsy and fiberoptic bronchoscopy. Specialty procedures include the use of ultrasound bronchoscopy, navigational bronchoscopy, percutaneous tracheostomy placement, chest tube insertion and pleurodesis.
PULMONARY LABORATORY: Modern, well-equipped pulmonary function and exercise laboratories are available for both in-patients and out-patients at each teaching hospital. These include spirometry, body plethysmography and blood gas analysis - including facilities for direct measurement of P50 as well as 2,3 DPG, blood lactate and pyruvate. Flow volume loops, closing volumes, carbon monoxide diffusion, and studies for exercise induced asthma are available. The Division directs a two-bed sleep laboratory at the VA Medical Center. Fellows may take optional electives in anesthesia/neurosurgery ICU, sleep disorders medicine, post-op thoracic surgery, pediatric ICU, renal consultative service, CCU, and Chest Radiology.
RESEARCH: All fellows are expected to accomplish scholarly activity during their Fellowship. They will participate in research for at least 3-6 months of their 36 month training period. Time in an area of research will depend upon interests and goals of the individual candidates. Active areas of research in this Division are sleep disordered breathing, sleep and cardiovascular disease, acute and chronic lung conditions such as asthma, chronic obstructive pulmonary disease, lung cancers and fibrosing lung diseases. The Division collaborates closely with the Department of Physiology and the Division of Allergy and Immunology and joint research projects are possible and encouraged.
TEACHING: All fellows are active in teaching. Teaching responsibilities are assumed in the course in physical diagnosis as well as the teaching of applied clinical pulmonary and pulmonary physiology for the house staff and medical students rotating on the service. The fellows are responsible for the day-to-day instruction of interns and residents in the diagnosis and care of patients with critical illness.
To view a list of all current fellows: click here